Córdoba R, Delgado M T, Pico V, Altisent R, Fores D, Monreal A, Frisas O, Lopez del Val A
Family and Community Medicine Teaching Unit, Zaragoza, Spain.
Fam Pract. 1998 Dec;15(6):562-8. doi: 10.1093/fampra/15.6.562.
The project was designed to compare the effectiveness of brief intervention (BI) versus simple advice (SA) in the secondary prevention of hazardous alcohol consumption.
A randomized controlled trial with a 12-month follow-up was conducted. A total of 74 community-based primary care practices (328 physicians) located in 13 Spanish autonomous regions were recruited initially. Out of 546 men screened, only 229 were randomized into BI (n = 104) and SA (n = 125); 44.6% of practices finalized the study. The interventions on the BI group consisted of a 15-minute counselling visit carried out by physicians which included: (i) alcohol quantification, (ii) information on safe limits, (iii) advice, (iv) drinking limits agreement, (v) self-informative booklet with drinking diary record and (vi) unscheduled reinforcement visits. The SA group spent 5 minutes which included (i), (ii) and (iii).
There were no significant differences between both groups at baseline on alcohol use, age, socioeconomic status and CAGE score. After the 12-month follow-up there was a significant decrease in frequency of excessive drinkers (67% of BI group reached targeted consumption, versus 44% of SA; P < 0.001) as well as weekly alcohol intake reduction (BI reached 52 versus 32% in SA; P < 0.001). A trend to improve outcome with the number of reinforcement visits was found with BI. The only predictor of success was the initial alcohol consumption level.
Brief intervention is more effective than simple advice to reduce alcohol intake on adult men who attend primary care services in Spain.
本项目旨在比较简短干预（BI）与简单建议（SA）在预防有害饮酒二级预防中的效果。
进行了一项为期12个月随访的随机对照试验。最初招募了位于西班牙13个自治区的74个社区基层医疗诊所（328名医生）。在546名接受筛查的男性中，只有229人被随机分为BI组（n = 104）和SA组（n = 125）；44.6%的诊所完成了研究。BI组的干预措施包括由医生进行的15分钟咨询问诊，内容包括：（i）酒精摄入量量化，（ii）安全限量信息，（iii）建议，（iv）饮酒限量协议，（v）带有饮酒日记记录的自我信息手册，以及（vi）不定期强化问诊。SA组花费5分钟，包括（i）、（ii）和（iii）。
两组在基线时的饮酒情况、年龄、社会经济状况和CAGE评分方面无显著差异。12个月随访后，过量饮酒者的频率显著下降（BI组67%达到目标饮酒量，而SA组为44%；P < 0.001），每周酒精摄入量也有所减少（BI组达到52%，而SA组为32%；P < 0.001）。发现BI组随着强化问诊次数的增加有改善结果的趋势。成功的唯一预测因素是初始酒精消费水平。
对于西班牙接受基层医疗服务的成年男性，简短干预在减少酒精摄入量方面比简单建议更有效。
